The Association Between Subcutaneous Fat Density and the Propensity to Store Fat Viscerally

Yeoh, Aaron; Pedley, Alison; Rosenquist, Klara J.; Hoffmann, Udo; Fox, Caroline S.

doi:10.1210/jc.2014-4032

Cited by 30 publications

(29 citation statements)

References 47 publications

(41 reference statements)

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“…Two prospective studies reported that increase in the change in abdominal VAT volume was associated with incident diabetes even after adjusting for weight change (19); and with incident hypertension after further adjusting for abdominal SAT volume change (20). Implementing radiographic imaging techniques to assess adipose tissue attenuation as a proxy of fat quality is a relatively newer measure (8,15,24,25). We have previously demonstrated the cross-sectional associations between lower attenuation of abdominal fat with adverse CVD risk factors (8), as well as longitudinal associations between baseline levels of abdominal fat quantity and quality with incidence and changes in CVD risk factors (9).…”

Section: Discussionmentioning

confidence: 99%

Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors

Lee

Pedley

Hoffmann

et al. 2016

Journal of the American College of Cardiology

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165

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BACKGROUND Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) are associated with adverse cardiometabolic risk profiles. OBJECTIVES This study explored the degree to which changes in abdominal fat quantity and quality are associated with changes in cardiovascular disease (CVD) risk factors. METHODS Study participants (n = 1,106; 44.1% women; mean baseline age 45.1 years) were drawn from the Framingham Heart Study Third Generation cohort who participated in the computed tomography (CT) substudy Exams 1 and 2. Participants were followed for 6.1 years on average. Abdominal adipose tissue volume in cm3 and attenuation in Hounsfield units (HU) were determined by CT-acquired abdominal scans. RESULTS The mean fat volume change was an increase of 602 cm3 for SAT and an increase of 703 cm3 for VAT; the mean fat attenuation change was a decrease of 5.5HU for SAT and an increase of 0.07 HU for VAT. An increase in fat volume and decrease in fat attenuation were associated with adverse changes in CVD risk factors. An additional 500 cm3 increase in fat volume was associated with incident hypertension (odds ratio [OR]: 1.21 for SAT; OR: 1.30 for VAT), hypertriglyceridemia (OR: 1.15 for SAT; OR: 1.56 for VAT), and metabolic syndrome (OR: 1.43 for SAT; OR: 1.82 for VAT; all p < 0.05). Similar trends were observed for each additional 5 HU decrease in abdominal adipose tissue attenuation. Most associations remained significant even after further accounting for body mass index change, waist circumference change, or respective abdominal adipose tissue volumes. CONCLUSIONS Increasing accumulation of fat quantity and decreasing fat attenuation are associated with worsening of CVD risk factors beyond the associations with generalized adiposity, central adiposity, or respective adipose tissue volumes.

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Section: Discussionmentioning

confidence: 99%

Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors

Lee

Pedley

Hoffmann

et al. 2016

Journal of the American College of Cardiology

Self Cite

165

117

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“…Of note, these investigators observed a similar degree of association between fat density and quantity as we observed in the MESA study (e.g., for visceral fat attenuation versus quantity, r=−0.72–0.75, depending on sex). These investigators have also recently identified a quantity-independent association of CT fat attenuation with all-cause and cancer-related mortality 6 and with preferential regional expansion of visceral vs. subcutaneous fat (a deleterious fat distribution profile) 25 .…”

Section: Discussionmentioning

confidence: 99%

Abdominal fat radiodensity, quantity and cardiometabolic risk: The Multi-Ethnic Study of Atherosclerosis

Shah

Allison

Lima

et al. 2016

Nutrition, Metabolism and Cardiovascular Diseases

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Background and Aims Fat radiodensity, as measured by fat attenuation on computed tomography (CT), has emerged as a potential biomarker of “fat quality.” We sought to characterize the relationship between fat radiodensity and quantity in subcutaneous, visceral, and intermuscular fat depots, and its role in inflammation, insulin resistance, and metabolic syndrome (MetS). Methods and Results We studied 1,511 individuals from the Multi-Ethnic Study of Atherosclerosis who underwent CT for measurement of regional fat distribution and radiodensity, along with biomarker assessments and adjudication of incident metabolic syndrome (MetS). Linear, logistic and Cox regression analyses were used to measure association between fat radiodensity and (1) fat quantity, (2) biomarkers of cardiometabolic dysfunction, and (3) both prevalent and incident MetS. In each fat depot, radiodensity was strongly and inversely associated with quantity (e.g., visceral fat radiodensity vs. quantity: ρ=−0.82, P<0.01). After adjustment for age, sex and race, lower visceral fat radiodensity was associated with greater C-reactive protein, leptin and insulin, but lower adiponectin (P<0.01 for all). After full adjustment for cardiovascular disease risk factors, visceral (but not subcutaneous or intermuscular) fat radiodensity was associated with prevalent MetS (OR=0.96, 95% CI=0.93–0.99, P=0.01). Moreover, lower visceral fat radiodensity was associated with incident MetS after the same adjustment (HR=0.95, 95% CI 0.93–0.98, P<0.01). However, this association became non-significant after further adjustment for visceral fat quantity. Conclusion Fat radiodensity is strongly correlated with fat quantity and relevant inflammatory biomarkers. Fat radiodensity (especially for visceral fat) may be a complementary, easily assessed marker of cardiometabolic risk.

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“…Second, the low attenuation of CT fat may reflect adipose tissue that is not affected by adipose tissue fibrosis, which allows the extracellular matrix remodeling of adipose tissues to accommodate adipocyte expansion . This notion can be supported by the association between elevated urinary connective tissue growth factor (ie, a marker of systemic fibrosis) and higher CT fat attenuation .…”

Section: Discussionmentioning

confidence: 99%

“…[39][40][41][42][43] Second, the low attenuation of CT fat may reflect adipose tissue that is not affected by adipose tissue fibrosis, which allows the extracellular matrix remodeling of adipose tissues to accommodate adipocyte expansion. 21,44 This notion can be supported by the association between elevated urinary connective tissue growth factor (ie, a marker of systemic fibrosis) and higher CT fat attenuation. 21 In line with this, a dose-dependent reduction of collagen type VI a3 gene expression (ie, gene that encodes fibrotic extracellular matrix protein) by leptin support the regulatory effect of leptin on cellular fibrosis.…”

Section: Potential Physiological Mechanismsmentioning

confidence: 97%

Cross‐Sectional Associations of Computed Tomography (CT)‐Derived Adipose Tissue Density and Adipokines: The Framingham Heart Study

Lee

Pedley

Hoffmann

et al. 2016

JAHA

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Background--Excess accumulation of abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) is associated with adverse levels of adipokines and cardiovascular disease risk. Whether fat quality is associated with adipokines has not been firmly established. This study examined the association between abdominal SAT and VAT density, an indirect measure of fat quality, with a panel of metabolic regulatory biomarkers secreted by adipose tissue or the liver independently of absolute fat volumes.

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The Association Between Subcutaneous Fat Density and the Propensity to Store Fat Viscerally

Abstract: High fat density, an indirect marker of fat quality, is associated with the propensity to store fat viscerally vs subcutaneously and is jointly characterized by an increased burden of CVD risk factors.

Cited by 30 publications

References 47 publications

Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors

Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors

Abdominal fat radiodensity, quantity and cardiometabolic risk: The Multi-Ethnic Study of Atherosclerosis

Cross‐Sectional Associations of Computed Tomography (CT)‐Derived Adipose Tissue Density and Adipokines: The Framingham Heart Study

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